Pediatr. Rep., Volume 12, Issue 2 (April 2020) – 7 articles

The outbreak of coronavirus disease 2019 pandemic forced the Italian Government to act extreme measures that put the entire country under lockdown. The citizens experimented a radical transformation of their lives while the healthcare system started building a novel COVID-system that quickly dissolved the former organization, included pediatric healthcare network. For a number of reasons COVID-19 pandemic is polite with children; however, the fear of this unknown disease drove to develop dedicated pathways in the Pediatric Emergency Departments for the suspected and diagnosed cases of COVID-19, together with their relatives. The combination of conflicting feelings resulted in an unexpected scenario: the number of accesses to the pediatric Hospital or Unit(s) sharply dropped to less than half. How do we explain this phenomenon? The authors believe that our health care system may learn a lesson from the catastrophe of COVID, if we will be able to redesign our way of providing our cares to children. Nothing should be taken for granted, because this might be a real “time for a change”. Full article

The main congenital pulmonary airways malformations in newborns and infants requiring surgery are cystic adenoid malformation, congenital lobar emphysema and bronchogenic cyst. The surgical treatment preferably via thoracoscopy is recommended within the first year of life to avoid the risk of pneumopathy. A monopulmonary ventilation is then required by the surgeon to operate the diseased lung. The anesthetic management of intraoperative mono-pulmonary ventilation in newborns and infants is always challenging for the anesthesiologist. The main objective of this study was to describe anesthetic protocol for thoracoscopy and variations of monitored parameters during a mono-pulmonary ventilation procedure in newborns and infants. Full article

Prenatal doppler ultrasound of the ductus venosus plays an important role in the evaluation of fetal circulation and fetal heart function. We aimed to establish the percentile of Resistivity Index (RI) and Pulsatility Index (PI) of the Ductus Venosus (DV) among normal Vietnamese fetuses with a gestation from 22 to 37 weeks in a cohort study. Normal Vietnamese fetuses with a gestation ranging from 22 to 37 weeks were examined in a cohort study. The PI and RI were recorded from the DV. We analyzed 640 participants who all fulfilled the inclusion and exclusion criteria of our study. Results: There was a significant correlation between RI, PI and gestational age as shown with the equations y = 0.077x – 0.003x² + 3.493e - 5x³ (r=0.97) and y = 0.106x – 0.004x² + 4.5e - 5x³ (r=0.94), respectively. A centile module was constructed for the DV RI and PI indices among normal Vietnamese fetuses with gestation from 22 to 37 weeks. Full article

Cesarean Section (CS) refers to the delivery of a fetus, placenta and membrane through the abdominal and uterine incision after 28 weeks of gestation. Unless used appropriately, the potential risk to the mother and baby becomes more than the vaginal delivery. Therefore, this study is designed to assess the determinant factors, trends and outcomes of caesarean delivery. Hospital based cross-sectional study was conducted from January 2015 to December 2016. All cesarean deliveries performed after period of viability (28 weeks) were included. The data was collected by using checklist and pretested questionnaire. The data was entered into EpiData and analyzed by SPSS version 21. There were 2587 deliveries in 2015 and 3423 deliveries in 2016, from those 440 and 660 were delivered by CS in each year respectively. The rate of CS in 2015 and 2016 was 17% and 19.3% respectively. The most common indication of CS was fetal distress. Mothers who had no antenatal care (ANC) follow-up had 3.16 times more risk for fetal death than mothers having ANC follow-up. We can conclude that the cesarean delivery rate is greater than WHO recommendation. ANC follow-up, parity, duration of labor, gestational age, types of CS and types of anesthesia are the main risk factors for CS and influence maternal and fetal outcomes. Full article

Recent developments in endovascular radiological techniques and devices have rendered embolization a major therapeutic option prior to surgery in many renal vascular or neoplastic diseases. A 19-yearold female patient, with a diagnosis of tuberous sclerosis complex (TSC) in childhood, was admitted with severe anemia. Polycystic kidney disease in end-stage renal failure appeared four years before and the patient has been undergoing peritoneal dialysis. The patient’s medical history also included bilateral renal angiomyolipomas (AMLs). One year earlier, a unilateral endovascular embolization was performed to repair a bleeding aneurysm at the right renal upper pole. A second bilateral ruptured renal aneurysm was diagnosed at admission. To continue with peritoneal dialysis and prevent intrarenal hemorrhage and intraperitonal bleeding, an urgent bilateral renal AE was performed. Two months later she underwent a bilateral retroperitoneal nephrectomy. The posterior surgical approach, preserved the peritoneal surface area and adequate conditions to continue dialysis. At histology, bilateral AMLs were confirmed and a renal cell carcinoma of the right kidney was concurrently discovered. She undergoes continuous peritoneal dialysis. Urgent selective renal AE represents a feasible treatment for bilateral AML bleeding. It is safe and feasible before performing nephrectomy in patients with end-stage renal failure. Full article

History of the reading disorder not due to an intellectual disability, inadequate teaching systems or poor motivation to study, referred to as developmental dyslexia, has very remote origins. The first attempts explain the disorder as a primary ‘visual defect’. Since then, several models have been developed until autopsy and histo-pathological studies on the brains of developmental dyslexics provided neuroanatomical evidence on the structural and morphologic differences between normal and dyslexic brains. In addition, the new neuroimaging technologies have allowed to understand the neural systems of reading and dyslexia. According to recent studies, developmental dyslexia appears as a neurodevelopmental multicomponent language-related disorder with a deficit in phonological decoding and in visuospatial organization of linguistic code. As a result, rehabilitation must be focused on the recovery of language and visuo-spatial and attentional processes underlying the complex and multi-component developmental dyslexia. This brief overview should be a valid tool for a deeper understanding of the dyslexic disorder. Literature searches in Medline, PsycINFO, EMBASE, Scopus, PubMed, Web of Science identified one hundred articles focusing attention on how this disorder has been considered over the years. Full article

Localized Cystic Disease of the Kidney (LCDK) is an extremely rare benign disease in pediatric population. Although its management is conservative and generally requires no treatment, the unfamiliarity with the disease can expose such patients to misdiagnosis as renal malignancies or uncertainty for proper treatment. We report such a case in an infant and review the current literature. Full article